急性脑缺血再灌注DWI及PWI的实验研究

Update Series l,2003,209

6　关长群,张玉忠,李爰娟,等.囊性肾癌的CT 诊断(附9例分析).中

国医学影像学杂志,1999,7(1):14

7　苑任,韩萍,史河水.囊性肾癌的CT 诊断.放射学实践,2001,16(6):

400

8　佐藤良延,大矢晃,高桥康之他.多房性囊泡状肾细胞癌の1例.临床

泌尿器科,1993,47(6):400

9　葛立,肖国文,何青.囊性肾癌1例.中华放射学杂志,1998,32(6):

431

10房世保,路晓东,王振虹.双侧囊性肾癌1例.中华放射学杂志,

1998,32(9):592

11陈宏伟,王德杭,夏晓,等.肾细胞癌边缘部CT 征象与病理对照研

究.临床放射学杂志,1999,18(6):354

12陈炽贤主编.实用放射学.北京:人民卫生出版社,2001,721

(2006211214收稿　2007201225修回)

急性脑缺血再灌注D W I 及P W I 的实验研究

刘国红1

　李良顺1

　周强1

　刘阳1

　游江林

2

【摘要】　目的:评价DW I 及P W I 判定急性脑梗死诊断及缺血半暗带的作用。材料和方法:40只S D 大鼠随机均分4组,A 组作假手术对照;B 、D 组分别栓塞2h 、6h,均再灌注2h 、24h;C 组栓塞2h 再灌注24h 、7d 。B 、C 、D 组于各自栓塞及再灌注时间点行DW I 、P W I 及常规序列扫描;后处理获得表观扩散系数(ADC )、脑血容量(C BV )、脑血流量(C BF )、平均通过时间(MTT )形态图。并将结果与四氮唑红(TT C )染色和病理作比较。结果:A 组DW I 、P W I 、TT C 染色及病理观察均无异常;B 、C 组栓塞时均可见右大脑中动脉供血区DW I 呈高信号,D 组异常信号区面积明显大于B 组,病理电镜表现为细胞内水肿。B 、D 组再灌注24h DW I 异常信号区面积与灌注前相比,B 组无明显变化,D 组较前增大;C 组再灌注

7d 6只大鼠DW I 见高信号,但ADC 图均正常。B 、D 组栓塞时右大脑中动脉供血区P W I 灌注缺损区面积相似。B 组P W I 异常信号面积大于DW I 异常信号区;D 组P W I 与DW I 异常信号面积无明显差别。结论:DW I 能灵敏反映急性期缺

血脑组织损伤情况,P W I 能灵敏反映组织血流灌注情况。DW I 、P W I 联合应用有可能判定缺血半暗带。关键词　急性脑缺血;灌注加权成像;扩散加权成像;缺血半暗带;再灌注;大鼠中国图书资料分类法分类号　R 445.2

D i ffusi on and Perfusi on M R I mag i n g of Acute Cerebra l Ischem i a w ith Reperfusi on:

A Exper i m en t i n Ra ts

L I U Guo 2hong,L I L iang 2shun,ZHOU Q iang,L I U Yang,YOU J iang 2lin (I m aging Cen ter ,Taizhou Puji Hospital,M ed 2ical College of Yang Z hou U niversity,Taizhou 225300)

【Abstract 】　Purpose:T o assess the value of DW I and P W I in evaluating penu mbra of acute cerebral ischem ia .M a ter i a ls and M ethods:

A t otal of 40S D rats were random ly divided int o four gr oup s .Gr oup A was sha m 2operated for contr ol study,Gr oup B,D were occluded f or 2,6hours and reperfused for 2,24hours res pectively .Gr oup C was occluded f or 2hours and reperfused f or 24hours,7days .DW I,P W I,T1W I,T2W Iwere perf or med bef ore and 2,24hours,7days after reperfusi on .ADC,CBV,CBF,M TT t opographical map s were reconstruc 2ted at the work stati on .The outcomes of serialMR Iwere compared with TTC stain and pathol ogical findings .Results:I n gr oup A,neither abnor mal signal of DW I,P W I nor pathol ogical changes were f ound .I n gr oup B,C,D hyper 2intensity signal occurred on DW I in the territ ory of m iddle cerebral artery after occlusi on .The regi on of abnor mal signal intensity on DW Iwas larger in gr oup D when compared with gr oup B,which corres ponding intracellular ede ma revealed by electr on m icr oscopy .T wenty 2four hours after reperfusi on,the area of hyper 2intensity in DW I was same as that before occlusi on in gr oup

B and larger in gr oup D.Seven days after reperfusi on in gr oup C,DW I showed abnor mal in six rats but AD

C returned t o nor mal in all the 10cases .Perfusi on deficitmaintained on P W I both in gr oup B and

D during occlusi on,but the area was larger than that of DW I in gr oup B and equal in gr oup D.Conclusi on:DW I can detect ischem ic lesi on sensitively and P W I can mo 2nit or he modyna m ics change sensitively,s o that combined DW I and P W Imay define ische m ic penu mbra .

Key words acute cerebral ische m ia;perfusi on 2weighted i m aging;diffusi on 2weighted i m aging;cerebral ische m ia reperfusi on;penu mbra;rats

作者单位　1.225300　泰州　扬州大学医学院附属普济医院影像中心

2.221000　徐州　徐州医学院附属医院影像科

脑梗死是常见病、多发病。目前对急性脑梗死的

治疗主要采用溶栓治疗使栓塞的脑供血动脉再通,使